2016 Volume 59 Issue 3 Pages 135-139
A 65-year-old woman visited our ENT hospital with the complaint of subjective left tinnitus, which felt like air escaping from the ear.
Magnetic resonance angiography revealed stenosis of the left internal carotid artery, and the patient was referred to the neuroendovascular surgeon at our hospital. Cerebral angiography carried out by this surgeon revealed stenosis (NASCET 75%) of the left carotid cavernous sinus. The patient strongly desired treatment, and endovascular treatment was performed. The left internal carotid artery obstruction was relieved by inflation of a balloon catheter, and the pulsatile tinnitus disappeared immediately. An endovascular stent (Tsunami®) was inserted to prevent re-stenosis and dissociation, completing the surgery. After 6 months of follow-up, there has been no re-stenosis or recurrence of the vascular tinnitus.
We should be aware of the possibility of vascular disease in patients presenting with pulsatile tinnitus and should perform thorough imaging studies to establish the cause.
